Delivering greater costing insights for Gloucestershire Health and Care NHS Foundation Trust

28th January 2019

Gloucestershire Health and Care NHS Foundation Trust provides a wide range of community services.

The Trust had challenges with their costing data which had limited ability to drill down below key service lines. Prior to the merger, with the implementation of Civica's CostMaster, cost information is available at individual patient and clinician level for 98% of services with a value of £90m. The costing calculation is now driven bottom up using patient contact times recorded by healthcare professionals on electronic clinical systems. This enables full tracing of patient journeys, giving valuable insight into areas where care is disjointed and costly, to support the Trust's ambitions to improve patient care and drive value.

The Trust's costing team agreed with clinicians and operational colleagues from the start, to share costing outputs as soon as available so they could work together to identify and resolve issues to enable better outcomes. Costing information is shared with the Trust's executive team, senior leaders, operational development and integrated community teams. To highlight cost of sub-optimal patient pathways, illustrate significant variation in staff grade delivering the same care intervention across different patients as well as demonstrating where community services are being consumed.

Civica and the Trust's Costing and Informatics teams worked closely to understand the best way to structure the activity data feeds to fulfil their ambition of reporting on both patient episode and contact costs. With Civica’s technical knowledge the structure was radically redesigned resulting in a dataset that fits the nature of the Trust's community services, meeting their reporting needs as well as using far less storage space.

The implementation of patient level cost data is enabling the Trust's operational and clinical leaders to better understand cost variation across different teams/localities, challenge existing service delivery models and evaluate potential improvements.


  • New, automated activity data feeds provides a stable, reliable and repeatable dataset to significantly enhance the quality of data
  • Identify and analyse the impact of variations in staff grade delivering similar interventions to inform workforce planning
  • Using Power BI to quickly and accurately present costing data in a meaningful way to clinicians and operational managers
  • Working with clinicians to investigate variations improves patient pathways and service delivery
  • Service development managers use costing information for new service commissioning.
Since we have implemented Civica's CostMaster, we have been working closely with our clinicians to identify cost variation to inform better decisions and improve outcomes.

Sandra Betney, Director of Finance and Performance, Gloucestershire Health and Care NHS Foundation Trust

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